NPIMap

Organization Active NPI

The Emeralds at St Paul LLC

  • Skilled Nursing Facility
  • Saint Paul, MN
National Provider Identifier
1447724091
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE EMERALDS AT ST PAUL LLC
Practice address
420 Marshall Ave
Saint Paul, MN 55102-1718
Phone
(651) 265-5736
NPI assigned
Jan 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Josh Legum
Title
Ceo
Phone
(507) 203-1001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

420 Marshall Ave
Saint Paul, MN 55102-1718

Mailing address

8833 Gross Point Rd Ste 208
Skokie, IL 60077-1859
Phone (507) 203-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190126000000 MN Part A Provider - Skilled Nursing Facility 6204173438 Practice locations: Saint Paul, MN

Skilled nursing facility certification: CCN 245295B

Legal name
THE EMERALDS AT ST PAUL, LLC
Organization structure
LLCProprietary
Incorporated
Jan 15, 2019 in MN
Enrollment address
420 Marshall Ave
Saint Paul, MN 55102-1718
Nursing home name
THE EMERALDS AT ST PAUL LLC
Affiliated entity
MONARCH HEALTHCARE MANAGEMENT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0673091Emeralds at St Paul, the420 Marshall Ave, Saint Paul, MN 55102Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Spartan Healthcare LLC Organization, Chicago, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2019 30%
WBS Holdings LLC Organization, Brooklyn, NY LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2019 20%
William Stern Individual 5% Or Greater Mortgage Interest Feb 1, 2019 20%
Corporate OfficerChief Financial Officer Feb 1, 2019 20%
Marc Halpert Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2019 30%
Corporate OfficerChief Operations Officer Feb 1, 2019 30%
Jeffrey Arem Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2019 10%
Monarch Healthcare Operating VIII LLC Organization, Mankato, MN LLC, For-profit Operational/Managerial Control Feb 1, 2019 100%
Joshua Legum Individual Contracted Managing EmployeeCeo Feb 1, 2019 30%
5% Or Greater Indirect Ownership Interest Feb 1, 2019 30%
Yazoma Holdings, LLC Organization, Skokie, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2019 30%
Noam Jaffa Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2019 10%
Corporate DirectorDirector of Procurement Feb 1, 2019 10%
Nij LLC Organization, St Louis Park, MN LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2019 10%
Jca Holdings LLC Organization, Brooklyn, NY LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2019 10%

Facilities with the same owner 44

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 44

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1447724091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8833 GROSS POINT RD STE 208",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771859",
            "telephone_number": "507-203-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MARSHALL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021718",
            "telephone_number": "651-265-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EMERALDS AT ST PAUL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-203-1001"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.